HESI RN
HESI Leadership and Management
1. Which of the following statements should be included in the teaching to a client about a do-not-resuscitate order (DNR)?
- A. When a heart ceases to beat, the client is pronounced clinically dead.
- B. Physicians are required to write DNR orders.
- C. A DNR order can be written after discussion with the client and family.
- D. A court decision is needed for a DNR.
Correct answer: C
Rationale: The correct statement to include in teaching a client about a do-not-resuscitate (DNR) order is that it can be written after discussion with the client and family. This involves ensuring that the client and their family understand the implications and make an informed decision. Choice A is incorrect as pronouncing clinical death is not directly related to discussing a DNR order. Choice B is incorrect as while physicians typically write DNR orders, it is not a strict requirement. Choice D is incorrect as a court decision is not typically required for a DNR order; it is a decision made by the client with input from healthcare providers and family members.
2. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:
- A. Gives small continuous doses of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
- B. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
- C. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
- D. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
Correct answer: A
Rationale: The correct answer is A. An external insulin pump delivers small continuous doses of regular insulin subcutaneously throughout the day to meet the basal insulin needs. The client can also self-administer a bolus dose with an additional dosage from the pump before each meal to cover the mealtime insulin needs. Option B is incorrect as insulin pumps do not typically release programmed doses of insulin into the bloodstream at specific intervals; instead, they infuse insulin subcutaneously. Option C is incorrect as insulin pumps are not surgically attached to the pancreas; they are worn externally. Option D is incorrect as NPH insulin is not commonly used in insulin pumps, and the pumps do not continuously infuse insulin directly into the bloodstream but rather subcutaneously.
3. Which advice is most beneficial for a new nurse manager?
- A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
- B. Keep in mind that it may take 6 months to feel at ease in a new role.
- C. Begin by mentoring other novice nurse managers.
- D. Participate in substantial personal growth endeavors.
Correct answer: B
Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.
4. Nurse Troy is aware that the most appropriate nursing diagnosis for a client with Addison's disease is:
- A. Risk for infection
- B. Excessive fluid volume
- C. Urinary retention
- D. Hypothermia
Correct answer: A
Rationale: The most appropriate nursing diagnosis for a client with Addison's disease is 'Risk for infection.' Addison's disease is characterized by corticosteroid deficiency, which leads to immune suppression, making these clients more susceptible to infections. This diagnosis reflects the increased vulnerability of clients with Addison's disease to infections. Choices B, C, and D are incorrect because Addison's disease does not typically present with excessive fluid volume, urinary retention, or hypothermia as primary concerns.
5. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
- A. Increasing saturated fat intake and fasting in the afternoon
- B. Increasing intake of vitamins B and D and taking iron supplements
- C. Eating a candy bar if lightheadedness occurs
- D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting
Correct answer: D
Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.
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